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Neurology SOH > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Epilepsy = seizure. True or false?

A

False

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2
Q

What is a seizure

A

Abnormal discharge of electrical activity in the brain

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3
Q

What is epilepsy?

A

Tendency to get recurrent seizures

Interruption of normal brain activity due to abnormal synchronisation of neuronal activity

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4
Q

Epileptic attacks are usually long/short?

A

Short

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5
Q

Focal seizures - definition

A

Discharge is confined to one area of the brain and doesn’t spread elsewhere.
Part of the brain is structurally abnormal which causes irritation and focal seizures in that area.

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6
Q

Simple focal seizure vs complex focal seizure

A

Simple - without impaired consciousness

Complex - with impaired consciousness

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7
Q

Focal epilepsy is more common in younger/older people?

A

Older

- because as you get older, you are more likely to have a structural brain abnormality

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8
Q

Generalised seizure - definition

A

Discharge spreads to more than 1 area of the brain.

There is more than one pathway involved.

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9
Q

Generalised seizures start a which networks?

A

Cortical networks

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10
Q

Generalised epilepsy is more common in younger/older people?

A

Younger

- has a genetic predisposition

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11
Q

Name the seizure: patient gets interrupted from participating in an activity and gives a vacant blank stare then resumes to activity

A

Absence seizure

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12
Q

What does myoclonus mean?

A

Body jerks

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13
Q

What is an atonic seizure?

A

Patient collapses to the ground and looses muscle tone

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14
Q

What are the characteristics of a tonic seizure?

A

Patient’s body goes rigid

There is an abnormal discharge in both motor cortices in the brain

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15
Q

Describe a tonic clonic seizure

A

Initially part of the body goes rigid and then later, the clonic component (jerking) occurs

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16
Q

Types of movements

A 
Stiff 
Rigid
Jerking 
Tongue biting 
Urinary incontinence
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17
Q

Questions to ask about after the event?

A

How long did it take to recover?

Sleepiness/disorientation

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18
Q

Which types of drugs can precipitate seizures?

A

Antibiotics

Tramadol

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19
Q

If a patient presents with their first seizure, they are routinely examined. True or false?

A

False

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20
Q

What are the rules of driving after first seizure?

A

Can’t drive car for 6 months

Can’t drive HGD/PCV for 5 years

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21
Q

For anyone who presents with a seizure, what is the first line investigation?

A

ECG

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22
Q

Imaging

A

MRI scan

CT scan

23
Q

EEG - what is it

A

Stick electrodes on the head and look for brainwave changes

24
Q

EEG is a useful investigation. True or false?

A

False

25
Q

What are the 4 purposes of EEG

A

How you classify someone’s epilepsy
To confirm non-epileptic attacks
Surgical evaluation
Conformation of non-convulsive status

26
Q

You should do an EEG in anyone under 30. Why is this?

A

To differentiate between generalised and focal seizures

27
Q

Management of focal epilepsy

A

Carbamazepine

Lamotrigine

28
Q

Considerations of drugs with carbamazepine

A

Makes contraceptive pill and morning after pill less effective

29
Q

Generalised epilepsy management

A

Sodium valproate

Lamotrigine

30
Q

Sodium valproate - side effets

A

Teratogenic

31
Q

Sodium valproate is more/less effective than lamotrigine.

A

More

32
Q

Management of generalised epilepsy - which drug is used more often: lamotrigine, sodium valproate?

A

Lamotrigine

33
Q

What is the first line treatment in generalised epilepsy

A

Lamotrigine

34
Q

Why must you start low and go slow with lamotrigine dosage?

A

If you start immediately on a high dose then it can cause steven johnson syndrome

35
Q

Management of absence seizures

A

Sodium valproate

Ethosuximide

36
Q

Management of myoclonic seizures

A

Sodium valproate

Clonezapam

37
Q

Patients on anti-convulsant medication should avoid which contraceptive pill?

A

Progesterone only pill

38
Q

Anti-convulsants affect the efficacy of the combined oral contraceptive pill and the morning after pill. True or false?

A

True

39
Q

Status epilepticus - definition

A

Recurrent epileptic seizures without full recovery of consciousness

40
Q

Status epilepticus - onging seizure activity for over _____ mins

A

30

41
Q

Status epilepticus - causes

A

Abrupt withdrawal from anti-convulsants
Head trauma
Sub-arachnoid haemorrhage
Infections

42
Q

Management of status epilepticus - if controlled

A

50ml 50% glucose if there is any suggestion of hypoglycaemia
IV thiamine if there is any suggestion of alcohol abuse or nutrient insufficiency

43
Q

SUDEP - definition

A

Sudden Unexpected Death in Epilepsy

44
Q

SUDEP - risk factors

A

Increased seizure frequency
Aspiration
Nocturnal seizures
Poor compliance with medications

45
Q

Non epileptic attack - definition

A

Unable to envisage where in the brain the abnormal discharge is coming from

46
Q

Non epileptic attack - causes

A

Traumatic events
Physical/Sexual abuse
Stress, anxiety, depression

47
Q

Non epileptic attacks - clinical features

A 
Coordinated movements 
- patient kicks legs 
- pelvic thrusts 
Patient has no control of the attacks 
Patient is conscious 
Patient is definite and absolute in what they experience
48
Q

Manage non epileptic attacks with anti-convulsants. True or false?

A

False

- these make the attacks worse

49
Q

Management of non epileptic attacks

A

Counselling

The patient will only recover once they accept what the underlying trauma is

50
Q

Nocturnal seizures are always the same. True or false ?

A

True

51
Q 
A patient presents with hypo pigmented skin, generalised seizures and fibromatas. What is the most likely diagnosis?
A men2
B men1
C neurofibromatosis 1
D neurofibromatosis 2
E tuberous sclerosis
A

Tuberous sclerosis

52
Q

Which anticonvulsant should never be given in generalised epilepsy?
Sodium valproate
Lamotrigine
Carbamazepine

A

Carbamazepine

53
Q

Febrile convulsions are a recognised risk factor for the development of focal onset seizures in which brain lobe in later life?

A

Temporal lobe

54
Q 
Which type of seizure involves characteristic pelvic thrusting and head turning movements?
Epilepsia partialis continua
Non epileptic disorder
Primary seizure
Generalised seizure 
Status epilepticus
A

Non epileptic disorder

Neurology SOH (31 decks)

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